The Case for Legalizing Medicinal Marijuana for Cancer Patients

Marijuana has been an illegal drug for more than thirty years now. Perhaps this is the reason that many people do not realize the fact that marijuana has a variety of benefits for certain diseases, and that it could help many people in this country in dealing with these diseases. Specifically, the use of marijuana would probably benefit a large number of cancer patients.

Chemotherapy, the treatment used for just about every cancer patient, is often associated with nausea, vomiting, and loss of appetite. Many patients do get relief from traditional medications, but there are also many patients who will only get the relief they need from using marijuana. Because of this, marijuana should be a legal, prescription drug that can be given to cancer patients who are not getting relief from any other medications. Doctors should be able to decide what type of medicine is best for their patients, rather than the government. In society today, it would be hard to get the government to change its stance on legalizing marijuana, but perhaps by raising public awareness about the benefits it can bring to a large number of people, the attitude of the government toward this issue may begin to change.

The marijuana or cannabis plant grows as a weed and is cultivated all over the world. The resin emanating from the flowers on female plants is a substance that holds chemical compounds which are responsible for both the intoxicating and medicinal effects of marijuana (Grinspoon, Bakalar, 1997, 2). Marijuana has a long history of being used in medicine. The first evidence of this was in China approximately five thousand years ago. It was used for a variety of ailments such as malaria, constipation, rheumatic pains, absentmindedness, and female disorders. Around the same time period, it was also use in India to quicken the mind, lower fevers, induce sleep, cure dysentery, stimulate appetite, improve digestion, relieve headaches, and cure venereal diseases (Grinspoon, Bakalar, 1997, 3). The first Western doctor to experiment with medicinal marijuana, W. B. O’Shaughnessy from the Medical College of Calcutta, used marijuana with patients suffering from rabies, rheumatism, epilepsy, and tetanus, and wrote about the drug’s value to medicine in 1839. When he began to provide pharmacists in England with cannabis, doctors across Europe and the United States began to prescribe the medication for a vast number of medical conditions (Grinspoon, Bakalar, 1997, 4).

With the development of synthetic drugs toward the end of the nineteenth century, the use of medicinal marijuana declined. Although medical experimentation could continue for a short time, the Marihuana Tax Act of 1937 eventually undermined this: “Under the Marihuana Tax Act, anyone using the hemp plant for certain defined industrial or medical purposes was required to register and pay a tax of a dollar an ounce. A person using marihuana for any other purpose had to pay a tax of $100 an ounce on unregistered transactions” (Grinspoon, Bakalar, 1997, 7-8). By the 1960s, the government’s concern about the recreational use of marijuana had begun to increase. In 1970, Congress passed the Comprehensive Drug Abuse Prevention and Control Act. This act assigned a variety of drugs to one of five schedules. Cannabis was placed in Schedule I (Grinspoon, Bakalar, 1997, 13). Legally, drugs assigned to Schedule I meet three criteria: “(1) high potential for abuse, (2) has no therapeutic value, and (3) is not safe for medical use (Mathre, 1997, 179). In 1972, two years later, the National Organization for the Reform of Marihuana Laws, or NORML, petitioned the Bureau of Narcotics and Dangerous Drugs to transfer marijuana to Schedule II. If this were to occur, marijuana could be legally prescribed by doctors. After a number of hearings and appeals, from 1972 until 1992, the Drug Enforcement Administration, or DEA, made a final statement, refusing to reclassify marijuana to Schedule II. NORML did, however, get delta-9-THC, a synthetic form of cannabis reclassified to Schedule II, but marijuana has never been reclassified (Grinspoon, Bakalar, 1997, 14-17).

A major argument in the case against legalizing marijuana, either fully or for medicinal use, is the belief that marijuana is a gateway drug, meaning that it will lead to use of stronger and more dangerous drugs. Marijuana is a gateway drug only in the sense that in recreational use, it usually precedes, rather than follows the use of other drugs. It is important to note that research on this has only been done with recreational use. This does not mean that the same pattern would be seen among users of medical marijuana (Mack, Joy, 2001, 64).

Medical marijuana would be helpful to a variety of people, especially those suffering from cancer. The treatment used for most cancer patients is chemotherapy. Chemotherapy is usually administered intravenously once every few weeks. The chemotherapeutic agents used are “among the most powerful and toxic chemicals used in medicine” (Grinspoon, Bakalar, 1997, 24). The chemicals are used to attack and kill cancer cells, but the chemicals cannot tell the difference between cancer cells and healthy cells, and chemotherapy does destroy many of the body’s healthy cells. Because of this, chemotherapy produces many extremely unpleasant side effects, the most common of these being nausea and vomiting, and with that, a loss of appetite. Some patients even develop a conditioned response in apprehension to treatment, and they will vomit upon entering the treatment room or when arriving at the hospital. Depending on the type of cancer, 50 to 80 percent of patients will also develop cachexia, “a disproportionate loss of lean body tissue” which also contributes to a weakened state (Mack, Joy, 2001, 101). If the nausea, vomiting, and cachexia are not controlled, the effectiveness of the treatment may be put in jeopardy because many patients will persuade their doctors to lower the dosages or lessen the treatment to reduce these side effects (Grinspoon, Bakalar, 1997, 24).

Many cancer patients do get sufficient relief from the medications prescribed to them. Antiemetic drugs, which decrease the vomiting and feelings of nausea, are usually used along with chemotherapy treatments. The most popular of these drugs include prochlorperazine or compazine, ondansetr or Zofran, and granisetron or Kytril. Zofran is now considered to be the most effective of these drugs, but all of these drugs carry the possibility that they will never work. (Grinspoon, Bakalar, 1997, 24). There are also a few treatments used for cachexia in some cases: “Standard therapies for cachexia include intravenous or tube feeding as well a treatment with megestrol acetate (Megrace), an appetite stimulant” (Mack, Joy, 2001, 101). The main problem with Megrace treatments is that they cause the patient to gain weight in the form of fat, rather than protein, which is what the patient really needs. Megace can also cause side effects such as hyperglycemia and hypertension (Mack, Joy, 2001, 101).

Marijuana would be very beneficial in the treatment of nausea and vomiting, as well as in the treatment of cachexia. Several different cannabinoids (forms of cannabis) have been tested for their ability to curb the feelings of nausea and the vomiting caused by chemotherapy. Four of the major compounds tested have proven “mildly effective in preventing vomiting following cancer chemotherapy” (Mack, Joy, 2001, 98). In a study analyzing a variety of trials done by the British Medical Journal, patients “overwhelmingly preferred cannabinoids for further chemotherapy” (Campbell, Carroll, Reynolds, Tramer, et al, 2001, 17). Marijuana may also help with cancer patients suffering from cachexia because marijuana is known for its ability to stimulate appetite without as many side effects as Megrace (Mack, Joy, 2001, 101). Marijuana may also be advantageous to cancer patients because of its relatively low cost in comparison to most of the other medications used to treat these side effects of chemotherapy.

The only marijuana-based medication available by prescription in the United States is called dronabinol, or “Marinol,” which is administered in pill form. Marinol has only been approved for use to treat chemotherapy-induced nausea and vomiting and to reduce cachexia in AIDS patients (Mack, Joy, 2001, 99). There is no strong support for the belief that smoked marijuana is better suited to relieve these symptoms in patients than Marinol. In one study comparing the two, it was found that both seem to prevent vomiting to a similar degree (Mack, Joy, 2001, 100). It does, however, seem to make sense that inhaling marijuana rather than swallowing a pill, would be better, especially for reducing vomiting and nausea. If the vomiting is severe, the oral marijuana would not be able to stay down long enough to be effective. Another advantage to inhaling marijuana is that it allows a patient to take in only the amount he or she needs to feel better. This would greatly reduce the risk of any side effects (Mack, Joy, 2001, 101). Because the smoking of marijuana can also cause a variety of side effects similar to those of smoking cigarettes, it is suggested that different methods of delivering the drug to the body be tested, such as using inhalers (Mack, Joy, 2001, 101).

Marijuana is not only useful in treating cancer patients. It has also been shown to help people with glaucoma, AIDS, neurological disorders, muscle spasticity, seizure disorders, and chronic pain. This evidence alone shows that it cannot honestly be classified as a Schedule I drug. It definitely does have some therapeutic value. Instead of blindly forbidding the use of marijuana in the United States, the government could look at how its use, with a doctor’s prescription, can benefit many members of society. This way, doctors and patients could make educated choices about the right medications to use in their treatment, without legal restrictions, and patients would be able to get the best possible medication; however, legalizing marijuana, even only for medicinal uses, would be hard to do in this country mainly because of the widely held belief that marijuana is a gateway drug to harsher and more dangerous substances. If oncologists would stress the upside of legalizing marijuana for their patient, that would add legitimacy to the argument. Testimonials by cancer patients what would illustrate the relief they would gain by smoking marijuana would also have impact. A public awareness campaign including both print and television media would also be beneficial. The case would have to be made to those who are not presently suffering the effects of chemotherapy, as well as to those who are. This case should be easy to make because no one is immune from cancer and most everyone is afraid of the pain and sickness associated with the disease and its treatment, or knows someone who is. The campaign to legalize marijuana for medicinal purposes and the eventual legalization of marijuana for these purposes would greatly benefit a large number of people who are currently suffering from this disease, and people who may develop this disease in the future.